Administrative Referral Coordinator

Description

POSITION DESCRIPTION

POSITION: Administrative Referral Coordinator

DEPARTMENT: Clinical Health Services

REPORTS TO: Director of Clinical Health Services

TYPE: Full Time

SALARY: $20.00 - $23.00

Summary:

Under the direct supervision of the Clinical Health Director the Administrative Referral Coordinator will manage the health center’s referral and authorization process for all health center patients.

RESPONSIBILITIES

Direct Patient Services

• Ensure accurate and complete referral/admission and patient tracking information by initiating and following up on all internal and external referrals on behalf of the Health Centers patients.
• Serve as an Ombudsman for the Health Centers patients and MCO’s or HMO’s regarding access to non-primary care services and coordinating the appeals process for denied services.

Administrative Duties 

• Keep detailed, accurate and complete records of referral activities to ensure appropriate visit frequencies as required for each payer per discipline.
• Review utilization and referral reports from all payors, identifying trends and patterns to management and coordinating the distribution of such reports to identified stakeholders.
• Maintain and make available to MCHC providers documented referral protocols, policies and procedures for all contracted MCO’s and HMO’s.
• Participate in the Health Centers outreach and education activities geared towards attracting new members and retaining current membership.

Performs other related responsibilities as assigned

Requirements

• High School graduate.
• Insurance verification and/or healthcare administrative background.  
• Demonstrated knowledge of health care principles and philosophies.  
• Excellent communications and organizational skills are a must.  
• Strong interpersonal skills and professional attitude.  
• Word processing and database skills are preferred.